| NPI | 1265480057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 3440) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 3754-33) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2015-10-28 |